Study On The Correlation Factors Of Resistant Mutations Associated With Adefovir Dipivoxil And Its Different Site Mutations

Objective:To explore the correlation factors of resistant mutations associated with adefovir dipivoxil(ADV) and its different site mutations.Methods:84patients infected by HBV who also experienced viral breakthrough during ADV monotherapy (duration>48weeks,including lamivudine(LAM) switching to ADV) were included in in this study. Pyrosequencing method was used to detect the hepatitis B virus polymerase (HBV P)gene. And the HBV DNA,HBsAg,HBeAg,HBV genotypes, ALT,AST,TBIL and liver imaging fingdings were analyzed simultaneously.Results:40out of83patients who had viral breakthrough were found to have mutations related to ADV (mutation group)and40were not found(non-mutation group). Older patients(>40),long history of ADV treatment, rtL180M had statistical significance(P=0.033,P=0.010,P=0.046,respectively) in multiple analysis,Out of40samples in the mutation group,14harbored rtA181T mutation,12harbored rtN236T mutation.In the multiple analysis,compared the group of rtN236T mutant and the group of rtA181T mutant,HBV genotype showed statistical significance(P=0,05,repectively).Conclusion:older patients(>40),long history of ADV treatment,rtL180M may be much easier to develop ADV mutation.HBV genotype B may be much more likely to occurt N236T mutation.